Individual
VIRGINIA DIANE RUDOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
3290 DAUPHIN ST STE 301, MOBILE, AL 36606-4052
(251) 660-5930
(251) 660-5931
Mailing address
PO BOX 21595, BELFAST, ME 04915-4112
(251) 300-5941
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3-000465
AL
363L00000X
Nurse Practitioner
902189
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
3-000465
AL
Other
Enumeration date
07/24/2017
Last updated
05/21/2024
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